July 2018
Volume 59, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2018
Identifying infants at lowest risk of developing any Retinopathy of Prematurity (ROP) among very low birth weight (VLBW) infants enrolled in the Telemedicine Approaches to Evaluating of Acute-Phase ROP (e-ROP) Study
Author Affiliations & Notes
  • Agnieshka Baumritter
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Kelly C Wade
    Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Graham E Quinn
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Gui-Shuang Ying
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Alice Gong
    Department of Pediatrics, University of Texas, San Antonio, Texas, United States
  • Alex Kemper
    Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio, United States
  • Footnotes
    Commercial Relationships   Agnieshka Baumritter, None; Kelly Wade, None; Graham Quinn, None; Gui-Shuang Ying, None; Alice Gong, None; Alex Kemper, None
  • Footnotes
    Support  National Eye Institute of the National Institutes of Health, Department of Health and Human Services U10 EY017014 and R21EY025686
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2751. doi:
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      Agnieshka Baumritter, Kelly C Wade, Graham E Quinn, Gui-Shuang Ying, Alice Gong, Alex Kemper; Identifying infants at lowest risk of developing any Retinopathy of Prematurity (ROP) among very low birth weight (VLBW) infants enrolled in the Telemedicine Approaches to Evaluating of Acute-Phase ROP (e-ROP) Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2751.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To identify characteristics of very premature infants considered at-risk for ROP by current AAP guidelines who will not develop ROP by hospital discharge/transfer.

Methods : Secondary analysis of prospectively collected ROP examination data from infants enrolled in the e-ROP study. We characterized infants without ROP during eye examinations at a given postmenstrual age (PMA) (noROPvisit) and those without any ROP at all examinations prior to study endpoint or hospital discharge/transfer (noROPhistory). Birth characteristics included birth weight (BW), gestational age (GA), multiple birth, gender and birth site. Respiratory status and nutritional support at 1st ROP exam were also included in the model.

Results : 1257 infants with BW <1251 grams underwent 4113 ROP study examinations between 31-47 weeks PMA including 1553 (38%) examinations that showed noROPpresent. 456 (36%) of all infants demonstrated noROPhistory on examinations prior to study endpoint/discharge/transfer. Among 247 infants born at 27-33 week GA, 237 (96%) did not receive treatment for ROP and 122 (49%) had noROPhistory. No infant with noROPhistory by >37 weeks PMA underwent treatment for ROP. In multivariable analysis, larger BW (>750g) and older GA (>28 weeks) both demonstrated more than 4-fold increased odds of noROPhistory (p<0.01). The prediction model with BW, GA, birth site and respiratory support had an area under ROC curve (AUC) of 0.74 (95% CI 0.68-0.80).

Conclusions : Absence of ROP on hospital examination in older PMA infants can further identify infants at lowest risk of developing severe ROP and potentially risk adjust the need for ongoing examinations. Efforts to determine which infants will not develop ROP in a longitudinal cohort and larger sample could be stratified by PMA to provide insights into risk of ROP treatment in this population and ways to minimize low-yield eye examinations, thereby reducing the burden for infants and families after the infant is discharged, and allowing focus of scarce resources on high risk infants.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

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